今日美术馆作品借展登记表
Today Art Museum Artwork Loan Registration Form
此表将根据作品特点由双方共同填写。
Both parties should fill out this form.
本人/单位______________向今日美术馆申请借展以下作品,用于________________ 展出:
Individual/ Institution _____________ applies to loan the work describes below from
Today Art Museum, for the exhibition___ _____:
名称:
Title:
地点:
Venue:
展期
Dates:
姓名: Name:
地址: Address:
电话: 传真: Tel.: Fax:
Email:
附注 Note:
艺术家姓名 :Artist: ? 先生 Mr. ? 女士 Ms.
作品名称: 英文 Title: English Title:
创作日期: Date:
材质: Media:
原作尺寸 (Original Size):
尺寸: 高 H cm/、宽 W cm/、 深 D cm;
Size: 包含外框或底座( Including frame or pedestal):
高 H cm/ 、宽 W cm/ 、深 D cm
重量: 包含外框或底座(Including frame or pedestal) kg Weight:
特殊安裝指示 / 安裝所需器材(Special Instruction on Installation/ Equipment Needed
for Installation): 装置: Installation:
展前提货地点: 地址:北京市朝阳区百子湾路32号 今日美术馆 电话: 010 58769804
Pick Up Address: Add: Today Art Museum, No.32 Baiziwan Lu, Chaoyang Tel.: 010 58769804
District, Beijing
展览归还出货地点: 地址: 电话: Return Address: Add: Tel.: 对于此借展作品,今日美术馆有权使用该作品在借展过程中产生的影像 / 图片资料:
For this piece of artwork on loan, Today Art Museum has the right to use the video and photography
documentations that are produced during the loan period:
? 同意 ? 不同意 a. 美术馆及相关网站. Museum and related website(s) Agree b. 画册及其它相关制作物;Catalogue and other related productions Disagree
? 同意 ? 不同意 (展览画册将订价对外出售) Exhibition catalogue will be for sale Agree c. 第三方公关用途之使用: (如展览相关广告、新闻、评论..等). Third party PR/ marketing Disagree
use (i.e., exhibition related advertisements, news, reviews etc.): ? 同意 ? 不同意 d. 第三方宣传播放之使用: (如展览相关广告、新闻、评论..等);Third party announcement Agree
Disagree use (i.e., exhibition related advertisements, news, reviews etc.): e. 教育及公关用途之平面出版品、电视/电影
片制作 Education and PR/marketing ? 同意 ? 不同意
Agree in graphic publications, television/film, documentary film production Disagree
? 同意 ? 不同意
Agree
Disagree 图片提供者(请务必确认您已取得著作权人同意):
Image provider (please be sure to confirm you already had permissions from the copyright holder): 为展览宣传之目的,新闻媒体将可能拍摄或录制您的作品,并刊登或播放于报纸(? 同意 ? 不同意)、杂志(? 同意 ? 不同意)、电视(? 同意 ? 不同意)及网络(? 同意 ? 不同意)
For the PR purposes of the exhibition, press and media can photograph and videotape your work and publish and play on newspapers (?Agree ?Disagree) 、magazines (?Agree ?Disagree) 、television (?Agree ?Disagree) and internet (?Agree ?Disagree)
摄影或录制过程中,可能会打光或使用闪光灯 (? 同意 ? 不同意)
In the process of photography, artificial lighting or flash light may be used (?Agree ?Disagree)
展览期间,北京今日美术馆保留拍摄会场记录的权利,您的作品将会在展览公关用途的实录中出现 (? 同意 ? 不同意) During the exhibition, Beijing Today Art Museum preserve the right t document the exhibition, your work will
be appear in the documentation of the exhibition for PR purposes (?Agree ?Disagree)
投保金额: (保险公司由双方协商决定) Insurance amount: (the insurance company is agreed by both parties)
出借者签名 年 月 日 Loaner’s Y M D Signature
部门负责人签名 年 月 日 Department Y M D Director’s Signature